Pneumothorax device



July 28, 1942. M. s. LLOYD PNEUMOTHORAX DEVICE Filed April 3, 1940 2Sheets-Sheet 1 m m ..M w mw L4 a M). u. I

July 28, 1942.

M. s. LLOYD 2,291,087

PNEUMOTHOHAX DEVICE Filed April 3, 1940 2 Sheets-Sheet 2 1 1?. Z. 1% 3INVENTORQ MILTON 5114.8 LLOYD AT TOR/VA? Patented July 28, 1942 UNITEDSTATES PATENT OFFICE PNEUMOTHORAX DEVICE Milton Sills Lloyd, StatenIsland, N. Y. Application April 3, 1940, Serial No. 327,691

6 Claims.

This invention relates generally to apparatus for the production ofsuction or pressure, and more particularly to a pneumothorax apparatusespecially suitable for the introduction of air pressure into thepleural cavity.

Among the objects of the present invention there is the provision ofstructure whereby the quantity of air being introduced into the pleuralcavity may be accurately measured and whereby the pressure in thepleural cavity may be measured, and may be accurately controlled.

Another object herein lies in the provision of a pneumothorax apparatuswhich is of a very compact nature so that the same is readily portablein use. In spite of its small size however, the device has a suitablecapacity so that even though the device is manually actuated in itspumping action, the number of manual operations to produce a givenquantity of air is reduced.

Another object herein lies in the provision of a pneumothorax apparatusin which the various liquid carrying containers may be suitably closedduring transportation of the device so that no leakage will occur.

A still further important object of the present invention lies in theprovision of certain safety control structure hereinafter more fullydescribed which automatically prevents the introduction into the pleuralcavity of any of the liquid which is utilized as a hydraulic pumpingmedium in the operation of the device.

In accordance with the present invention, the pneumothorax apparatus isof simple and durable construction so that the same may be manufacturedat low cost and may thus have a widespread use. The durability of thedevice permits reliance upon it by the physician since it is foolproofand will not fall to operate in emergency. Furthermore, even if theattention of the physician is diverted, it is impossible to operate thedevice in an incorrect manner.

A further feature of the present invention lies in the fact that noauxiliary source of power is required so that the same may be properlyoperated wherever the patient may be located regardless of the proximityof any electrical power source.

A further feature of the present invention lies in the fact that inaccordance with the present construction, the internal portions of themechanism may be maintained in a sterile condition and the air which isintroduced into the pleural cavity is filtered so that foreign matter isautomatically removed therefrom.

These objects and other incidental ends and advantages will more fullyappear in the progress of this disclosure and be pointed out in theappended claims.

In the drawings, similar reference characters designate correspondingparts throughout the several views, in which:

Fig. 1 is a view in perspective showing an embodiment of the presentinvention as set up and ready for use. In this figure the hydraulicpumping fluid is shown in the upper container and at the beginning ofthe pumping operation.

Fig. 2 is an enlarged central vertical sectional view of the pumpingmeans.

Fig. 3 is a fragmentary view taken similarly to Figure 2, showing,however, the pump in an inverted position and the valve rotated throughas compared with Figure 2.

Fig. 4 is a fragmentary elevational view as might be seen from the rightside of Figure 2 and showing in detail the valve means.

Fig. 5 is an enlarged fragmentary vertical sectional view showing indetail the valve control mechanism. In this figure the parts are shownas they would appear if seen from the right side of Figure 3.

Fig. 6 is a view similar to figure 5 with the valve mechanism in aninverted position as compared with Figure 5. In this figure the partsare shown as they would appear if seen from the right side of Figure 2.

In accordance with the invention the pneumothorax apparatus is indicatedgenerally by numeral HI, and includes generally the casing II, thepumping means H, the manometer Hi, the filter conduit I4, the deliveryconduit l5, and the injector It. The pumping means I2 acts as a sourceof pneumatic pressure which is delivered to the three-way valve l1. Atthis point the air under pressure may be injected into the pleuralcavity by way of the delivery conduit IS. The manometer I3 permits anaccurate check on the various pressures as will be fully describedhereinbelow.

The pumping means l2 comprises generally a pair of containers l8 and I9which are preferably of a durable transparent material such as thickglass. In accordance with constructions of the invention which have beenfound satisfactory in use, each of the containers preferably has acapacity of 330 cubic centimeters. A body element or coupling unit 20contains the valve means 2i and is adapted for detachable hermeticconnection with the containers IB and I9. The coupling unit 20 has asubstantially rectangular main body portion thereof is provided conicalcylinder 23 in tatable valve element valve element 24 disposed in 23 isfrusto-conical in shape.

The main body portion 22 is provided with a plurality of orifices 25,26, 21 and 28 which communicate with the conical cylinder 23. Theorifices 25 and 21 are aligned on a single vertical axis, and theorifices 26 and 28 are similarly aligned. The body portion 22 isprovided with another pair of orifices 29 and 30 which are aligned andcommunicate with the conical cylinder 23.

The body portion 22 is provided with two circular portions, the edges ofwhich extend beyond said body portion, and form the flanges 3| and 32.The circular flanges 3| and 32 have the edges thereof adapted forthreaded engagement with the coupling collars 33 and 32'. The flanges 31and 32 have the inner (that is, facing the containers l8 and I3)surfaces thereof provided with counter bores or circular depressionswhich are adapted to act as seats for the mouths of containers l8 and I9and are provided with suitably arranged gaskets which lie between theedges of the said mouths of the said depressions. The coupling collars33 and 34 have integral inwardly extending annular flanges 35 and 36.The internal diameter of the flanges 35 and 36 is slightly greater thanthe external mouths of the containers I3 and I9 which are in turn ofgreater diameter than the neck portions 31 and 38 of the containers l8and I9.

Annular resilient gaskets 39 and 40 are of a particular cross sectionclearly seen in Figure 2, so that they complement the adjacent surfaces.In assembling the coupling collars 33 and 34 on the mouths of thecontainers l8 and 19, the coupling collars are first placed over themouths of the bottles so that they rest upon the neck portions 31 and 33respectively. Subsequent to this operation the resilient gaskets 39 and40 are stretched into place over the mouths of the containers l8 and I!)so that the said gaskets act, not only to promote a hermetic sealthereat, but also act to prevent the coupling collars from falling offthe mouths of the containers. If desired, the gaskets 39 and 43 may bebonded to the internal surfaces of the coupling collars 33 and 34.

The orifices 29 and 3B are counterbored to provide seats for the airinlet tubes 41 and 42, which are preferably composed of a non corrodablematerial such as brass or monel metal. Graduated indicator strips 43 and44 are aflixed to and project laterally from the tubes 4| and 42. Thegraduation on the strips 43 and 44 may be at any suitable intervals asdesired. The tubes 4| and 42 may be either permanently affixed withinthe orifices 29 and 33 or may be frictionally detachably engageabletherewith. The tubes 4| and 42 are of sufiiclent length when supportedas described, so that they reach almost to the bottoms of the insides ofthe containers l8 and I9.

The rotatable valve element 24 is provided with a plurality of channelsor passages 45, 46 and 41. The passage 45 extends through the handleportion 48 of the said valve element and diverges at substantially aright angle to be in line with either orifice 29 or orifice 30 when thevalve element 24 is properly seated within the conical cylinder 23. Thepassage 45 is angularly disposed within the valve element 24, as clearlyseen in the drawings, so that one end thereof 22 and along the longestaxis with a horizontally disposed which is disposed a ro 24. The portionof the the conical cylinder may line up with the orifice 25 or 21 whilethe other end will line up with the orifice 26 or 28.

The passage 41 is disposed in the delivery portion 49 of the valveelement 24 and is of irregular figuration so that the inner end ofpassage 41 is adapted for ultimate communication with either orifice 25or orifice 21. The valve element 24 is maintained in rotatable operativeposition in conjunction with the conical cylinder 23 by means of thewasher, expansive coil spring and nut assembly H). The delivery portion49 is adapted to be connected to the filter conduit 14 in any suitablemanner, as for example. by the coupler tube 5| which is elasticallyengaged by the lower end of the conduit l4 and is frictionally engagedwithin the outer end of the passage 41.

The valve control mechanism generally indicated by numeral 52, includesdetents 53 and 54 which may be small horizontally disposed pins whichproject from the surface 55 of the main body portion 22. The radiallyprojecting pin 55 coacting with the detents 53 and 54 limits therotation of the valve element 24 to about the horizontal axis. A doublepawl 51 includes the ratchet ends 58 and 53. The pawl 51 is looselypivotally mounted upon block 60, which is in turn attached to thevertical surface 6| of the body portion 22. The configuration of thefree end of the pawl 51, is such, and the position thereof with relationto portion 48 is such, that the said portion acts to limit verticalreciprocation of the free end of said pawl. The portion 48 disposedadjacent the pawl 51 is provided with a pair of diametrically opposedoutwardly projecting radial pegs 61 and 52 which coact with said pawl.The outer end of the handle portion is provided with a handle 63 havingat the periphery thereof a guide pointer 64.

The casing II is composed of a pair of boxlike elements 65 and 66; theelement 65 may be considered as the box bottom and the element 66 as thecover member. The two box elements are hingedly interconnected, providedwith a handle 61, latching means 68, and adjustable brace 69. Theinternal shape and size of the box bottom 65 is such that it is able tocontain the pumping means I2 while the inside of the cover member 65 hasattached to the inner surface thereof the manometer l3. Since theconstruction of the manometer and its use in connection with themeasuring of pneumatic pressures is well known in the art, the same willnot be described in very great detail.

The U tube 18 is maintained in position with relation to the covermember 68 by means of a pair of clips 1!. The free end of the manometeris provided with a stop cock 12. The filter element 13 is preferablycomposed of a cylinder of transparent material and has packed thereinany suitable filter elements such as cotton wool," or glass wool. Thedelivery conduit 15 may be composed of any suitable tubing such asrubber, and the injector i6 is preferably a hollow hypodermic typeneedle associated with the free end of the conduit 15 by means of aconnector 14.

Operation ing position" (with the indicator guide pointer top of t egraduated scale 44. If it does not, neck of the bottle reduces thevolume of the rethe containers may be again reversed and sufiimammgliquid to approximately 50 cubic centicient water added by the samemeans to bring meters A manometer reading is generally taken the waterup to the desired level The total volafter each 100 cubic centimeters ofair 1s deuntil the water level in both arms of the U tube If, for anyreason, a greater air pressure is deis at zero on the scale 75. Coloringmatter may sired, the speed of delivery of air to the chest be added tothe water in the manometer also may be increased by attaching a rubberbulb with Tincture of metaphen makes a suitable vehicle a Luerconnection to the inflow end of the valve for this purpose. About twocubic centimeters and forcing air into the upper bottle under presissufficient to color the water in the containers, sure. When theuppermost container is emptied. and four drops for the manometer. Inboth inthe valve is closed and the pumping means I2 is stances thecoloring matter should be put in first inverted. In turning the pumpingmeans, a usetainers may, of r e, e dismounted y loosenof the conduit isprevented. The upper containsity of replacing a container due tobreakage, this For deflation the apparatus is used in the same is notnecessary, since the containers can be way except that the coupler tube5| is placed either filled or emptied through the outflow end into theouter end of the passage 45.

of the air control valve. The valve stem or ro- When the apparatus isnot used, a positive or tatable element 24 may be freed by removmg thenegative pressure (above or below atmospheric nut, s ring, and washerassembly from the out pressure) is maintained equal to the height of amay be removed by removing the screw in block 5 about 14 centimeters andfalls as the liquid de- 60.

The manometer i3 is located in the lid or cover the upper container isemptied. The length of member 65 of the carrying case ll. When the thegraduated scales are approximately 12 cenlid is raised, the stop cook 12is opened, (the timeters and the depth of the valve is approxiindicatorhandle of the stop cock standing in a mately2 centimeters. verticalposition). The three-way valve I1 is If the injector l6 which is usedhas a large turned so that the indicator points to the right. enoughinternal bore to carry the full flow of air time, that is to say,initial treatment refill or delivery of air, by subtracting the existingpressure upright pos t on in the box With the particular eter reading.Hence, with the water level in the container within which the water isthen located upper container at a "5," a pressure of plus 9 placeduppermost. The passage 41 is connected centimeters will be delivered. Ifthe manometer by means of the conduit l4 to the lower end of 05 readingis then plus 8, plus 2, the intrapleural the valve l1. pressure will beminus 1, minus 7. When the inometer reading has been obtained, thehandle 63 therefore. obvious that, when the known pressure tle upwardand turn the valve to the working position. This permits balancing theatmospheric pressure.

Transportation of the complete apparatus with all valves closed willresult in no loss of the liquid from the system.

The operation of the valve control mechanism will be best understood bya perusal of Figures 4, 5 and 6 of the accompanying drawings. As viewedin Figure 2, it will be seen that all of the radially arranged portionsof the passages I5, 46, 41 are in the same plane. The pin 56, as viewedin Figure 2, projects upwardly and rests against detent 53. The pegs GIand 62 project horizontally from the portion 58. The position of theparts at this stage is best seen in Figure 6, only the radially disposedportion of the passage 41 being shown in dotted lines for the purpose ofclarity. In this position air compressed in the lower container i9passes outwardly through the passage 41. As soon as all of the liquidhas flowed from the container 18 into the container IS, the handle 63 isgrasped and is rotated through 90 in a counter-clockwise direction, asviewed in Figure 6 (the detent 53 preventing rotation at this time inclockwise direction). The parts will then take the position shown inFigure 4 in which the peg Si is prevented from rotating in acounter-clockwise direction by the action of the ratchet end ing meansi2 is inverted and the action of gravity will cause the pawl 51 to dropand the parts will take a position in which the ratchet end 59 restsupon the upper surface of the portion 48. In this position it will thenbe impossible to rotate the handle 63 in a clockwise direction, sincethe peg 62 will abut the ratchet end 59. The handle 63 is next rotatedin a counter-clockwise direction, as viewed in Figure 5, until itreaches the position shown in said figure. the pin 55 strikes the detent54, this sequence of operations is continued until the desired pressureor vacuum is created by the pumping means. It, therefore, follows thatat any given position of the pumping means, that is, whether or not thecontainer H3 or the container I! is lowermost, only two positions of thevalve stem or rotatable element 24 are possible, one, a working positionin which the passage 41 is disposed downwardly, and two, an off positionin which the inner end of the passage 41 and the corresponding orifices25 or 21 are disaligned.

It may, therefore, be seen that I have disclosed a novel and usefulpneumothorax device which is compact, light in weight, durable,efficient, very convenient to use and completely foolproof in operation.The device may be composed of durable and yet low-cost materials such asbronze and glass, so that no undesirable corrosion takes place, and theinstrument may be sold at low cost and have a long useful life.

I wish to be understood that I do not desire to be limited to the exactdetails of construction shown and described for obvious modificationswill occur to a person skilled in the art.

I claim:

1. A pneumothorax device comprising: a body element, a pair ofcontainers detachably associated with said body element, a plurality ofapertures in said body element communicating with each of saidcontainers, and valve means adapted in a first position thereof topermit air under pressure to flow from one container, in a secondposition to stop air flow, and in a third position to permit air underpressure to flow from the 58. At this stage the pumpother container, andmovable control means restricting the movement of said valve means topermit the fiow of air from a container only when it is in the lowerposition thereof.

2. A pneumothorax device comprising: a body element, a pair ofcontainers detachably associated with said body element, a plurality ofapertures in said body element communicating with each of saidcontainers, and valve means adapted in a first position thereof topermit air under pressure to flow from one container, in a secondposition to stop air fiow, and in a third position to permit air underpressure to fiow from the other container, and gravity operated movablecontrol means restricting the movement of said valve means to perm't theflow of air from a container only when it is in the lower positionthereof.

3. A pneumothorax device comprising: a body element, a pair ofcontainers coaxially aligned and detachably associated with said bodyelement which is disposed between said containers, a plurality ofapertures in said body element communicating with each of saidcontainers, and valve means adapted in a first position thereof topermit air under pressure to flow from one container, in a secondposition to stop air fiow, and in a third position to permit air underpressure to flow from the other container, and movable control meansrestricting the movement of said valve means to permit the flow of airfrom a container only when it is in the lower position thereof.

4. A pneumothorax device comprising: a body element; first and secondcontainers detachably connected to said body element; said body elementhaving a plurality of apertures therein communicating with each of saidcontainers; valve means adapted in the first position thereof to permitair under pressure to flow from the first container, in the secondposition to stop air flow and in the third position to permit air underpressure to fiow from the second container; and gravity operated movablecontrol means preventing manual movement of said valve means to thefirst position thereof when the device is resting on the secondcontainer, and preventing manual movement of the valve means to thethird position thereof when the device is resting on the firstcontainer.

5. A pneumothorax device comprising: first and second containers eachhaving a neck portion; a coupling unit including a body element, valvemeans, and gravity operated movable control means coacting with saidvalve means; said body element detachably engaging both of said neckportions on opposite sides of said body element whereby the containersare oppositely disposed with the body element therebetween, bothcontainers being thereby integrated and movable as a unit; said bodyelement having a plurality of apertures therein communicating with eachof the containers, said valve means being adapted in a first positionthereof to permit air under pressure to fiow from the first container,in the second position to stop air flow and in a third position topermit air under pressure to flow from the second container; saidgravity operated movable control means acting to prevent manual movementof the valve means to the first position thereof when the device isresting on the second container, and to prevent manual movement of thevalve means to the third position thereof when the device is restingupon the first contamer.

6. For use with a pneumothorax device of the class having a pair ofoppositely disposed containers holding a charge of liquid and whichcompresses air in the lowermost of the containers when the device isinverted; a valving structure adapted to be connected to each of saidcontainers, said valving structure comprising a body element having acylinder substantially horizontally disposed when the device is in anoperative position, said body element having a plurality of juxtaposedorifices communicating with said containers and said cylinder; arotatable valve element disposed within said cylinder; means to preventrotation of the valving element in excess of substantially one hundredeighty degrees; a gravity acting double pawl movably mounted on saidbody element; a pair of oppositely disposed projections on said valvingelement coacting with the ends of said double pawl whereby rotation ofthe valving element is restricted to substantially ninety degrees withinthe said one 0 hundred eighty degrees.

MILTON SILLS LLOYD.

